Lusaka, Zambia — The novel coronavirus pandemic laid bare the stark disparities in global access to essential medicines. The world's most vulnerable populations were often left behind in the scramble for life-saving vaccines, diagnostics, and therapeutics. This underscored the urgent need for a paradigm shift in global health security and local production as a pivotal step towards bolstering healthcare resilience and accessibility worldwide.
In February 2021, UN Secretary-General Antonio Guterres described vaccine equity as the "biggest moral test before the global community."
Despite the challenges, Africa's vaccine manufacturing future is looking more promising.
A new era of vaccine production is dawning
At the International Conference on Public Health in Africa (CPHIA) held in Lusaka, Zambia, high-level delegates and experts assembled to explore the pressing need for accelerated local vaccine manufacturing across the continent, aiming to address vaccine shortages and promote self-reliance.
In Africa, less than 1% of vaccines used are locally produced, with the vast majority being imported from private sector suppliers around the globe. However, over the past two years, Africa has made significant strides in the production of medical commodities, with a particular focus on vaccines. The African Union, Africa CDC, and various international partners have been involved in supporting infrastructure and capacity in vaccine delivery, as well as in facilitating engagement with the private sector and international organizations to expand vaccine manufacturing in Africa.
This continent-wide effort has the potential to reshape the relationship between local communities in Africa and the global health sector.
More than 30 new vaccine manufacturing initiatives are currently underway in Africa, signaling a significant expansion of the continent's vaccine production capacity. This effort is aimed at safeguarding Africa against future pandemics and disease outbreaks, as well as reducing the delays and challenges faced in accessing vaccines, as experienced during the COVID-19 pandemic.
Africa CDC Director General Dr. Jean Kaseya pointed to the critical role of local vaccine manufacturing in safeguarding the health and well-being of Africa's citizens. He added that achieving self-sufficiency in vaccine production is a cornerstone of the continent's journey towards comprehensive healthcare security. The Partnerships for African Vaccine Manufacturing (PAVM) is spearheading this ambitious endeavor, which recently received a significant boost with the backing of the global vaccines platform, Gavi," said Kaseya.
Dr. Kaseya said that the African Union, along with its members and partners, set an ambitious goal in 2021 to achieve at least 60% local production of vaccines by 2040. This initiative, driven by the COVID-19 pandemic, has underscored the urgent need to strengthen Africa's pharmaceutical manufacturing capabilities.
He acknowledged that Africa has faced challenges in the past, particularly in terms of infrastructure, logistics, and production capacity. However, he expressed his determination to overcome these obstacles and create a robust ecosystem for manufacturing vaccines and other medical products.
To address these challenges and advance the local manufacturing agenda, Dr. Kaseya announced the establishment of a Platform for Harmonised Africa Health Products Manufacturing (PHAHM).
"Therefore, I have decided to create a directorate that will lead this agenda and in a few days, I hope most African people will have the opportunity to send applications for all of the positions we are creating starting with the position to lead the platform that we are talking about," he said.
He urged all African citizens to apply for positions within the newly created directory that will oversee all aspects of local manufacturing.
Africa's pursuit of diagnostic and manufacturing self-reliance
Professor Abderrahmane Maaroufi, the Director of the Institut Pasteur Maroc (National Public Health Institute) added that Africa is steadily progressing towards self-sufficiency in diagnostics and manufacturing, with notable advancements achieved in recent years. The African Union has spearheaded several initiatives to foster local production of essential health products, and there is a burgeoning commitment among African nations to invest in this domain.
"Initiatives like the African Collaborative for Advanced Manufacturing of Vaccines and the establishment of Centers of Excellence are commendable," he said. "However, challenges persist, such as limited technology and distribution barriers hindering local manufacturing's full potential."
Maaroufi said that the advantages of local manufacturing of diagnostics and therapeutics are that it is both more cost-effective and efficient. He noted that Africa currently manufactures less than 2% of its required diagnostics and therapeutics, with a staggering 97% being imported from outside the continent. This reliance on external sources can hinder Africa's ability to effectively combat diseases.
Vaccine development and pandemic preparedness
Frederick Kristensen, the Deputy CEO of the Coalition for Epidemic Preparedness Innovations (CEPI), said that as we grapple with the lingering impacts of COVID-19 and confront other devastating outbreaks, the need for robust health security has never been more evident.
"We've witnessed devastating outbreaks, emphasizing the urgency of investing in health security. Climate change further complicates accessibility, amplifying the need for rapid response," he added.
"We're at a historic juncture where science, technology, finance, and political will converge, offering an unprecedented opportunity to enhance pandemic preparedness. African countries, through initiatives like the Africa CDC, are tackling these challenges collectively. Our contributions include supporting vaccine manufacturing capacity in Senegal and South Africa and aiding volunteers in developing an mRNA-based vaccine."
"The 100-Day Mission, endorsed by parties like the G7, aims to have vaccines ready within a hundred days of identifying threats," he said. "This shift from preparedness response necessitates global, locally-driven manufacturing for swift, top-quality vaccine production. Focusing on crucial factors among the myriad of infectious diseases could significantly expedite responses."
"Strengthening regulatory agencies and improving clinical trial protocols are essential to safely and efficiently evaluate countermeasures. Achieving this requires building capacity sustainably, leveraging existing research infrastructure, and fostering local expertise," he said. "In a significant step forward, we have partnered with the Medical Research Council of the Gambia and the International Vaccine Initiative to enhance clinical research capacity in West Africa. This initiative is already gaining momentum, and we aim to expand it to other regions, such as East Africa."
Global health architecture and partnerships
Echoing the sentiments of her fellow delegates, Heidy Rombouts, the Belgian Director General for Development Cooperation and Humanitarian Aid at the Belgian Ministry of Foreign Affairs acknowledged the glaring deficiencies exposed by the COVID-19 pandemic in global health systems, emphasizing the urgent need for a comprehensive overhaul of the international health landscape.
"The theme of 'Repositioning Africa in the Global Health Architecture' is undeniably compelling," she asserted. "It should resonate far beyond the continent, engaging the global community in a concerted effort. But what does this repositioning entail for us, as partners engaging with Africa and preparing for the next pandemic?"
Rombouts announced that Belgium would hold the EU presidency from January 1st for six months. "I have come to this conference with an open mind, eager to listen and learn more about what 'repositioning' means for us - for Europe, for the European Union, and our partnership with Africa," she remarked.
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To strengthen partnerships in the health sector, Rombouts advocated for expanding collaboration to encompass a broader range of actors, including regulatory bodies, primary healthcare providers, market analysts, and market intelligence providers. She acknowledged that this may necessitate stepping out of comfort zones, forging new networks, and cultivating collaborative relationships with diverse communities. In addition, she emphasized the importance of enhancing communication strategies to effectively demonstrate how development finance institutions can support market initiatives and leverage investments in primary healthcare.
"Partnerships must extend beyond a single level," Rombouts asserted, echoing the adage "No one is safe until everyone is safe."
"We must engage at all levels, from local to regional, sub-regional, continental, and global. Technology can play a pivotal role in consolidating local information for faster decision-making at regional and sub-regional levels," she explained.
"Partnerships will be multi-layered," Rombouts said, citing Belgium's collaboration with Senegal and Rwanda to strengthen local health systems and regulatory bodies within the Team Europe approach as an exemplary model. This initiative aims to boost local manufacturing of vaccines, medicines, and health technologies in Africa, with a focus on creating an enabling environment for sustainable production and strengthening regulatory structures."
"Engaging in a mutual learning process and facilitating two-way learning through twinning arrangements are key aspects of this journey," she said.
AllAfrica's reporting from CPHIA2023 is supported by the African Union and Africa CDC
